Provider Demographics
NPI:1710793468
Name:PSYCURE MODERN PSYCHIATRY
Entity type:Organization
Organization Name:PSYCURE MODERN PSYCHIATRY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:BEVERLEE
Authorized Official - Last Name:KUSI
Authorized Official - Suffix:
Authorized Official - Credentials:PMNP-BC
Authorized Official - Phone:877-779-2873
Mailing Address - Street 1:8210 MACEDONIA COMMONS
Mailing Address - Street 2:SUITE 3B PMB 1096
Mailing Address - City:MACEDONIA
Mailing Address - State:OH
Mailing Address - Zip Code:44056-2264
Mailing Address - Country:US
Mailing Address - Phone:877-779-2873
Mailing Address - Fax:
Practice Address - Street 1:8210 MACEDONIA COMMONS
Practice Address - Street 2:SUITE 3B PMB 1096
Practice Address - City:MACEDONIA
Practice Address - State:OH
Practice Address - Zip Code:44056-2264
Practice Address - Country:US
Practice Address - Phone:877-779-2873
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-07
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health